异位胰胆管共同开口在胆胰疾病诊断和治疗中的意义

The implication of ectopic opening of the pancreaticobiliary duct in the diagnosis and treatment of cholangiopancreatic disease

目的探讨异位胰胆管共同开口在内镜逆行胰胆管造影(ERCP)操作及胆胰疾病诊断和治疗中的意义。方法总结4年来1000例ERCP检查中发现的5例胰胆管共同通道开口异位部位和特点,以及异位乳头周围黏膜病变及胆胰病变特点。结果5例中乳头开口异位于胃窦部1例,十二指肠球部2例,十二指肠降部远段2例。5例中胆总管结石3例,胰管结石1例,胆胰正常1例;位于胃窦及十二指肠球部2例均有黏膜糜烂病变。结论胰胆管共同通道开口异位可能会影响乳头发现,但只要认真寻找,并不会影响ERCP检查。在有异位开口病人中,胆胰疾病发病率增加,乳头周围黏膜病变也增多。

Objective To discuss the implication of ectopic opening of the pancreaticobiliary duct in the performance of cholangiopancreatcography （ERCP） and the diagnosis and treatment of cholangio pancreatic disease. Methods We summarize the data of 1000 cases of ERCPin the past four years. Five patients were found with ectot）ic opening of the pancreaticobiliary duct. The positions, characteristics of ectopic opening and the characteristics of the mucosa disease around the ectopic papilla and cholangio- pancreatic disease were analyzed. Results In the 5 patients with ectopic opening of the papilla, one had the opening in the pyloric channal, two in the duodenal bulb. the other two in the distance of the descending part of duodenum. Mucosa erosion was found in the patients with ectopic opening in the pyloric channal and in the duodenal bulb. Conclusion The eetopic opening of the pancreaticobiliary duct may affect the finding of the papilla, but may not affect the performance of ERCP. The incidence of the cholangiopancreatic disease and the mucosa disease around the ectopic papilla will increase in the patients with ectopic opening.